Life and Health
Insurance companies from adverse selection by high risk persons.
The Medical Information Bureau (MIB) was created to protect
Control specialist costs
The gatekeeper of an HMO helps
Renewal provision
Which health insurance provision describes the insured's right to cancel coverage?
15-day waiting period/10 year benefit period
Which of the following disability income policies would have the highest premium?
The Medicare Part A deductible
Which of the following is not covered under Plan A in Medigap insurance?
Teaches and non-for-profit organizations
A 403(b) plan, commonly known as a TSA, is available to be used by
Stop-loss limit
An insured has endured multiple surgeries and hospitalizations for an illness during the summer months. Her insurer no longer bills her for her expenses. What term best describes the condition she has met?
Annually Renewable Term
All other factors being equal, the least expensive first-year premium payment is found in
Interest
During partial withdrawal from a universal life policy, which portion will be taxed?
Hedge against inflation
Fixed Annuities provide all of the following EXCEPT
Coverage ends and the policy cannot be reinstated
What happens when a policy is surrendered for its cash value?
The original age is used for premium determination
What is the advantage of reinstating a policy instead of applying for a new one?
15 days
A client has a new disability income policy with a 20-day probationary period and a 30-day elimination period. Ted days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?
10 days
An insured pays monthly premium of $100 for her health insurance. What would be the duration of the grace period under the policy?
Rates by class
Insures may change which of the following on a guaranteed renewable health insurance policy?
Regulates consumer reports.
The Federal Fair Credit Reporting Act
The insurer is considered to be notified since the notification to agent equals notification to the insurer.
When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?
Military service or war
What is the name of a clause that is included in a policy that limits or eliminates the death benefit if the insured dies as a result of war or while serving in the military?
Level or flexible
Which two terms are associated directly with the premium?
When the application is signed and a check is given to the agent
What is the earliest a policy may go into effect?
As long as the policy is in force
What is the maximum amount of time during which an insurer may contest fraudulent misstatements in a health insurance policy?
Proof of insurability is not required
A couple owns a life insurnace policy with a Children's Term rider. Their daughter is reach the maximum age of dependent coverage, so she will have to convert to permanent insurance in the near future. Which of the following will she need to provide for proof of insurability?
Separate Accounts
A domestic insurer issuing domestic contracts must establish one or more
Critical Illness
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
Level term
A policy will pay the death benefit insured dies during the 20-year premium-paying period, and nothing if death occurs after the 20-year period. What type of policy is this?
Managed Care
A woman's health insurance policy dictates which doctors she is allowed to see. Her health providers share a risk for their patients and encourage preventative care. What best describes the health system that the woman is using?
Copy of the original application
According to the entire contract provision, what document must be made a part of the policy?
Neither approved the application nor issued the policy.
An applicant for a health insurance policy returns a completed application to her agent, along with a check for a first premium. She receives a conditional receipt two weeks later. Which of the following has a the insurer done by this point?
Donut hole
An insured has medicare part D coverage. He has reached his initial benefit limit and must pay 50% of his prescription drug costs. What is the term for this gap in coverage?
Pay the death benefit
An insured purchases a policy in 2008 and died in 2013. The insurance company discovers at the time that the insured concealed information during the application process. What can they do?
Contracts of Adhesion
Contracts that are prepared by one party and are submitted to the other party on a take-it-or-leave-it basis are classified as
A member of an HMO can receive care in or out of an HMO service area, but care is preferred in a service area.
How is emergency care covered for a member of an HMO?
Loss of an eye
In a disability income policy, all of the following are considered presumptive disabilities EXCEPT
Assets
In a replacement situation, all of the following must be considered EXCEPT
is not covered
In health insurance, if the doctor charges $50 more than what the insurance company considers usual, customary and reasonable, the extra cost
Not tax deductible
Premium payments for personally-owned disability income policies are
At least 1,000 employees
SIMPLE Plans require all of the following EXCEPT
As of the application date
The full premium was submitted with the application for life insurance, and the policy was issued two weeks late as requested. When does the policy coverage become effective?
Are made by the business and are not tax-deductible
Under a Key Person disability income policy, premium payments
The insured
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to
Insurers are bared from requiring HIV testing.
Which of the following statements regarding HIV testing is NOT true
Disability Buy-Sell
Which agreement specifies how a business will transfer hands when one of the owners dies or becomes disabled
Pay Benefit
Which of the following allows the insurer to relieve a minor insured from premium payments if the minors parents have died or become disabled?
Size of each installment
Which of the following determines the length of time that benefits will be received under the Fixed-Amount settlement option?
Reimbursements
Which of the following is NOT provided by an HMO?
The longer the elimination period the lower the cost of coverage
Which of the following is true regarding elimination periods, and the cost of coverage?
Adult-day care
Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?
Target Premium
Which of the following would help a universal life policy from lapsing?
Notice of claim
Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss?
Change any incorrect statement on the application by personally initializing next to the corrected statement.
All of the following are duties and responsibilities of producers at the time of application EXCEPT
The employer can receive a current tax deduction for any contributions made to the plan.
All of the following statements concerning an employer sponsored nonqualified retirement plan are true EXCEPT
FINRA
An agent selling variable annuities must be registered with
It is reduced to the amount of what the cash value would buy as a single premium
When a reduced-paid up nonforfeiture option is chosen, what happens to the face amount of the policy?
Allison is insured by a High Deductible Health Plan (HDHP)
Which of the following individuals is eligible for a Health and Saving Account?
Policy loans are tax deductible
Which of the following is INCORRECT regarding whole life insurance?
To create an estate
Which of the following is the best reason to purchase life insurance rather than annuities?
Physical examination and autopsy
Which of the following provisions is mandatory for health insurance policies?
Insuring clause
Which provision of a life insurance policy states that insurers duty to pay benefits upon the death of the insured, and to whom the benefits will be paid.
Respond to the consumers complaint.
Under the Fair Credit Reporting Act, if the customer challenges the accuracy of the information contained in his or her report, the reporting agency must
A statement that is sufficiently clear to identify the insured and the nature of the claim
Under the mandatory provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
90 days of loss
Under the uniformed required provisions, proof of loss under a health insurance policy normally should be filed within
Attending Physician's Statement
What document describes the insured's medical history, including diagnoses and treatments?
Impairment Rider
Which of the following riders would NOT increase the premium for a policyowner?
Suicide is excluded for a specific period of years and covered thereafter.
Which of the following statements about a suicide clause in a life insurance policy is true?
The policyowner is entitled to policy loans.
Which of the following statements is true regarding a whole life policy?
The insurance company
Who bears all of the investment risks in a fixed annuities
An individual not covered by an employer-sponsored plan who has earned income.
Who can make a fully deductible contribution to a traditional IRA?
The same face amount as in the whole life policy
Under an extended term nonforfeiture option, the policy cash value is converted to
Unearned premiums are retained by the insurance company.
According to the right of renewability rider for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy EXCEPT
Unilateral
In insurance policies, the insured is not legally bound to any particular action in the insurance contract, but the insurer is legally obliged to pay losses covered by the policy. What contract element does this describe?
Insurer to the insured
In the event of a loss, after a notice of claim is submitted to the insurer, who is responsible for providing claims forms and to which party?
The insured may choose to convert to term or permanent individual coverage.
Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In November, he has a small claim which is less than his deductible. Which of the following is true?
It allows the insured to reject the policy with a full refund.
What is the purpose of the free-look period in insurance policies?
